Incontinence Part 2

November was national incontinence and bladder health awareness month in the U.S. As lots of the training resources I use come from there it seemed an ideal time for me to bang on about my favourite subject again! I've already covered stress incontinence, which is the most prevalent /stress-incontinence/ But there are other types as well. And bear in mind incontinence isn't just urine, it can also be faecal

• Stress - leaking due to a change in pressure on the bladder eg jumping, running, sneezing, laughing
• Urge - a sudden and overwhelming urge to go. Leaking before have chance to get to the loo
• Overflow/dribble - bladder doesn't empty fully so leaking occurs without necessarily having had an urge to wee

Incontinence is not an unavoidable consequence of ageing and childbirth. Things can be done to prevent it and/or improve it. It's always worth seeing a doctor and getting a referral to a women's health physiotherapist. Instead of masking the problem with pads etc - you need to find the reason and make a lifestyle change! Things that can affect the pressure within the pelvis:

• Posture - try to keep your ribs stacked up over your pelvis when standing and sitting
• Clothing - too tight clothing can compress and move your organs. High heels will make you tilt your pelvis in order to be able to stand upright
• Diet - avoid foods/drinks that irritate the bladder or cause gas
• Exercise - move more, sit less

Exercise needs to be functional, so that you're using movements you need in everyday life - squats, lunges in all directions, hip hinges. Exercise can also have a negative effect if the exercise you're doing is too much for the pelvic floor to withstand. Any exercise that makes you hold your breath, bear down, shake, really clench, lose postural cues or leak needs to be avoided for now. Another useful part of your life to look at is your toilet habits as straining can cause huge problems.

• Wee every 3-4 hours - try to avoid going 'just in case'. You just need to relax to wee so don't hover above the seat. Rocking the hips a little at the end can help if you feel like you haven't emptied fully.
• Poo when you feel the urge - don't hold it in as this can cause compaction. Knees should be higher than your hips - feet up on a kids stool or just use 2 loo rolls. Don't strain. If the pelvic floor won't relax you can help by vocalising - try a grrr or ssss now and see which one makes you feel like your pelvic floor relaxes. Then use that sound when on the loo.

And finally - keep practising the knack /knack-pelvic-floor-health/